Reproductive Medicine

Causes of Infertility

During your consultation, we will discuss your history of periods, surgery or prior pregnancies. We will also discuss your partner’s history at this visit and he/she is encouraged to come but not required. The consultation helps to determine the next step in exploring why you may be having a difficult time getting pregnant. About one-third of the cases of infertility are caused by factors that affect the woman, one-third by factors that affect the man. For the remaining one-third, the cause may be a combination of problems in both partners or it may be unknown. For many couples, not knowing is the hardest part.

Here are some of the most common causes of infertility:

Problem with ovulation, like polycystic ovary syndrome (PCOS) — a hormonal imbalance that interferes with normal ovulation. If your periods are irregular or skip months, it may be a sign of an ovulation problem.

Blocked fallopian tubes, which may be due to a pelvic infection, endometriosis or prior surgery, can affect the ability to be pregnant.

Physical problems with the structure of the uterus and presence of uterine fibroids are associated with infertility and repeated miscarriages.

Being overweight or underweight can affect a woman’s ability to get pregnant. Obesity is a problem found in about 50 percent of women with PCOS. Diet and exercise that result in weight loss are likely to improve the frequency of ovulation and enhance a woman’s ability to get pregnant. We will help you understand the best ways to optimize your weight for pregnancy.

Male infertility may result from the absence of sperm, a low sperm count, abnormally shaped sperm or poor movement of the sperm (motility). The shape of the sperm — called morphology — can affect the ability of the sperm to fertilize the egg. Physical injury, infection or other damage to the reproductive system may block the sperm. In rare cases infertility in men is due to a genetic disease such as cystic fibrosis.

Social changes have affected fertility rates in our country as more women choose to wait until their late 30s or 40s before starting a family. In fact, roughly 20 percent of women in the United States now have their first child after age 35. Age contributes to infertility in women in a variety of ways. Older women have fewer eggs and their eggs have poorer quality. With all these factors combined, about one-third of couples in which the woman is age 35 or older have fertility problems. We do see age-related fertility decline in men but usually not until their 50s.

Infertility Testing

We offer comprehensive testing and evaluation for both women and men — to help you understand why getting pregnant has been a challenge.

Some of the evaluations you may have include:

Blood tests for hormone levels

An ultrasound to check for follicles or cysts

Semen analysis for the man

A hysterosalpingogram (HSG) — an x-ray test to check the uterus and determine if the fallopian tubes are open